The Marshfield Clinic family is committed to making a positive impact on our patients and our community. We are here every step of the way to support you in making the best decisions about your health and wellbeing, from research and prevention to diagnosis and treatment. So you won't only live your life, but shine.

Anxiety is a feeling of distress, fear or uneasiness. There are several different types of anxiety disorders, but they all have the common symptoms of excessive, irrational fear and dread. If left untreated, anxiety disorders can grow progressively worse, making it difficult to function in everyday life. Some symptoms of generalized anxiety include:

trembling

insomnia

feeling of a loss of control

racing pulse

difficulty breathing

dizziness

muscle aches

Talk with your doctor or nurse if you are having any of these symptoms or problems.

Tips for dealing with anxiety

Realize that anxiety is a normal reaction to a cancer diagnosis and treatment.

Talk with your doctor or nurse about what you are feeling for direction in managing your symptoms.

Get enough sleep, and exercise daily if you are able.

Try relaxation techniques, such as yoga, meditation, and deep breathing.

Join a cancer support group.

Keep a cancer treatment journal. When possible, take action to resolve those matters that you can control.

Constipation is the difficulty in passing stools, a decrease in the normal frequency of your bowel movements or the passage of hard, dry stools.

Constipation can be accompanied by nausea, gas related pain or pressure in your stomach. It can be caused by anything that slows movement through the intestines, including some chemotherapy drugs, some antiemetics and pain medications, lack of physical activity and decreased fluid intake and/or poor nutrition.

Constipation can sometimes be a symptom of other problems. An unexpected change in bowel habits or symptoms should be reported to your doctor or nurse. Here are some tips for dealing with and preventing constipation

Eat or drink foods or fluids that have helped relieve constipation in the past

Eat food high in fiber such as raw fruits and vegetables with skins and peels on (after they have been washed), bran, whole grain breads and cereals, or whole prunes. Talk with your doctor, nurse or dietician if you have no appetite, problems chewing or swallowing, feel full quickly or are on a low fiber/low-residue diet before eating these foods.

Add Activity or exercise into your daily routine

Call your doctor or nurse immediately if you have any of the following symptoms

Constipation is unrelieved

Pain in your stomach

Blood in your stool

Fever higher than 100.5 degrees Fahrenheit by mouth

You are not able to pass gas

Nausea or vomiting (throwing up) along with constipation

If your stomach looks swollen and/or feels hard to touch

If you have not had a bowel movement in three days despite following the above instructions

Chemotherapy may affect your appetite in different ways. Food may taste different; sour and bitter tastes may be more intense, and sweet food may taste bland. You may even have a metallic taste in your mouth. Radiation therapy can affect your taste buds, making food tasteless. Taste changes may last 2 to 3 months or longer after treatment ends.

You may have a feeling of being full without eating much or any food at all. You may also have less of a desire to eat if you’re experiencing feelings of anxiety or depression.

Tips for dealing with decreased appetite

Rinse your mouth with water or salt water before eating; brush your teeth after meals, at bedtime and as needed for comfort.

Eat 5 or 6 small meals and snacks each day

Drink fluids between meals.

Try nutritional supplements, such as liquid meal replacements

Ask family or friends to help you with cooking and shopping.

Chew ginger or mint to decrease a metallic taste in your mouth.

Add flavorings to your food, or suck on sugarless hard candies or mints.

Depression is a persistent feeling of sadness that interferes with your ability to complete daily activities.

Factors that can increase your likelihood of becoming depressed include:

your physical condition

poorly controlled pain

personal history and/or a family history of depression

certain medications

The symptoms of depression include:

Depressed mood for most of the day and feeling like this on most days

Loss of pleasure and interest in most activities

Nervousness or sluggishness

Restlessness

Fatigue

Changes in eating and sleeping habits

Feeling of guilt, worthlessness and hopelessness

Difficulty concentrating and making decisions

Thoughts of suicide or hurting yourself or others. If you experience thoughts of suicide or hurting yourself or others, it’s important to tell someone – a family member or friend, your doctor or nurse – immediately.

If you experience any of these symptoms consistently for a 2-week period, you should talk with your doctor or nurse.

How to get help for depression

Talk with your doctor or nurse; they can put you in touch with a counselor, social worker or other health care professional

Chemotherapy can damage the cells In your gastrointestinal tract and cause loose, watery, bowel movements. Diarrhea can lead to poor appetite, weight loss, weakness and dehydration. Diarrhea can become life-threatening if it is not brought under control.

Diarrhea may be relieved by restricting what you eat, drinking plenty of fluids and by using an anti-diarrhea medication.

Tips for dealing with diarrhea:

Call your doctor or nurse immediately if you have a fever higher than 100.5 degrees Fahrenheit by mouth, severe stomach cramps or bloody stools with diarrhea.

General instructions for over the counter anti-diarrhea medication: Begin taking Imodium® (loperamide) 2 tablets (4 mg) with first sign of diarrhea, then 1 tablet (2 mg) after each loose bowel movement up to 8 tablets in a 24 hour period.

Instructions for Imodium® intense (physician ordered) over the counter anti-diarrhea medication - Follow these instructions only if your doctor or nurse directs you:

Begin taking Imodium® (loperamide) as follows at the first sign of diarrhea – Take 2 tablets (4 mg) immediately, followed by 1 tablet (2 mg) every 2 hours during the day, and 2 tablets (4 mg) every 4 hours during the night until you have no diarrhea for 12 hours

Set your alarm to wake up during the night to take your dose on schedule

Call your doctor or nurse if diarrhea continues for 12 hours

Eat smaller amounts of food throughout the day.

Drink at least six to eight 8-ounce glasses of fluids every day to prevent dehydration. This includes water, sports drinks, juice, or clear broth.

Minor skin problems are a common side effect of cancer treatments, including dry, itchy skin and skin rashes. A skin rash can indicate an allergic reaction to therapy. Ask your doctor or nurse if there are creams and other special skin care products available to help decrease rashes caused by chemotherapy treatments.

Tips For Dealing With Dry Skin And Rashes

Use mild soaps and cleansers.

Dry skin carefully after bathing. Pat your skin dry, do not rub it.

Moisturize skin frequently.

Expose the affected skin to the air as much as possible, but avoid exposure to the sun.

Hair loss (alopecia) can be a side effect of certain chemotherapy drugs.

Hair loss usually begins 2 to 3 weeks after chemotherapy treatment starts. The amount of hair you lose depends on the chemotherapy you receive. The good news is that your hair will grow back. Hair usually starts to grow back 1 to 2 months after chemotherapy ends.

It can be difficult to prepare yourself for the loss of your hair. It’s OK to allow yourself to grieve the loss of your hair. Encourage family members, especially children, to express their thoughts and feelings about your hair loss. Remember, losing your hair does not change who you are as a person.

Tips for dealing with hair loss:

Get a short haircut before you begin treatment. It may help make your adjustment to hair loss easier.

Shop for a wig before your hair is gone, especially if you wish to match your natural color. Some insurance companies cover the cost of a wig.

Anemia is a decrease in the number of red blood cells and amount of hemoglobin, a protein that helps your blood carry oxygen. Anemia results in your blood being unable to carry oxygen throughout your body. Cancer-related anemia can be caused by chemotherapy, radiation therapy, iron deficiency, bleeding, the cancer itself or a combination of these or other things.

Anemia makes you feel tired. If you are anemic, you may also have the following symptoms:

Difficulty thinking

Dizziness and weakness

Shortness of breath with mild activity

Pale skin

Rapid heartbeat

Feeling cold all the time

Loss of sex drive

Depression

Call your doctor if you have:

Shortness of breath or chest pain

Dizziness when you get up from lying or sitting down

Paler skin than normal

Extreme tiredness that is not helped by sleep OR you have been too tired to get out of bed for the past 24 hours

Felt confused or cannot think clearly

Tips for dealing with anemia

Eat small, balanced meals every 2 to 3 hours. The best sources of iron are beef and other meats. Additional sources of iron include beans, lentils, iron-fortified cereals and dark green, leafy vegetables. Foods containing vitamin C, such as citrus fruits, help increase iron absorption.

Stay as active as you can. At least 10 to 30 minutes daily of light exercise can ease tiredness.

Take short naps, but do not let them interfere with your nighttime sleep.

Take your time getting up from a lying or sitting position. Getting up too fast can make you dizzy and cause you to fall.

When your blood counts are low, you may be at higher risk of getting an infection.

Your doctor can tell if you have neutropenia by ordering a complete blood count (CBC). Your risk depends on:

How low your white blood count falls

How long your white blood count is low

Which type of low white blood cell count you have

Other medications you may be taking (Check with your doctor or nurse before getting immunization shots.)

Tips for preventing infection:

Drink 2 to 3 quarts of fluids each day.

Eat a balanced diet

Cook eggs, fish, and meat

Wash all food before you eat it

Clean any cuts with soap and water and apply an antibiotic ointment

Do not use tampons

Wash your hands frequently with warm, soapy water, especially before eating and after using the bathroom

Take a warm bath or shower daily. Pat your skin dry

Rinse your mouth often and brush teeth with a soft toothbrush after eating. (Check with your doctor before having dental work done.)

Ask family or friends to clean up after pets for you

Avoid adults who have shingles or children who have chicken pox or measles

Avoid constipation

Avoid crowds and stay aware from people who are sick with colds, flu, or other infections you can catch

Do not cut or tear your nail cuticles

Do not have sexual intercourse

Do not use rectal or vaginal suppositories

Wear gloves to wash dishes or to garden

Tips for dealing with neutropenia and infection:

Have all blood tests (lab work) done as ordered.

Check your temperature if you feel hot and “sweaty”, cold and “chilled”, or you are not feeling well when your white blood count is low. Call your doctor or nurse immediately if you have any of the following symptoms or problems:

A fever higher than 100.5 degrees Fahrenheit by mouth

Shaking chills

New symptoms of burning, pain or blood when passing urine

Call your doctor or nurse within 24 hours if you experience any of the following:

Diarrhea with fever

New symptoms of coughing along with shortness of breath

Sore mouth or throat

New or unusual vaginal discharge or itching

Redness, swelling, pus, or pain surrounding a cut or wound on your skin

When your white blood cell count is low you may NOT have the usual signs and symptoms of an infection. Therefore, it is very important to be alert to any change in how you feel and report/discuss what you are feeling with your doctor or nurse.

Chemotherapy can affect the cells in your bone marrow, mouth and throat, making you more susceptible to infection and bleeding. You can prevent infection, improve your appetite and improve comfort by keeping your mouth clean.

There are medications that your doctor can prescribe to prevent, lessen, or relieve the nausea and vomiting associated with chemotherapy. These medications are called anti-nausea drugs or antiemetics. Some of these medications are given before chemotherapy treatments in the hospital or clinic, but you may also be given prescriptions to take at home.

Tips for dealing with nausea and vomiting:

Eat small, frequent meals.

Eat and drink slowly and chew food thoroughly.

Eat soft, bland foods; such as toast, crackers or breadsticks.

Eat and drink food/fluids that are cold or room temperature.

Do not let yourself get hungry. Have snacks available.

Have other people cook for you whenever possible. Smells may bring on nausea and vomiting. Sometimes it helps to have food prepared outside the home or eat out.

Pain may be a side effect of a cancer treatment, caused by surgery or the cancer itself. There are effective treatments for pain control. Often, medicines are used in combination with other treatments for best pain relief.

Tips for dealing with pain:

Keep a diary or journal of your pain

Call your doctor or nurse if you have new pain or pain that is not controlled by your pain medication within 24 hours

Take your pain medication as prescribed.

Do not let the fear of addiction cause you to not take your pain medication as prescribed

Breast Cancer Video

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Test Your Knowledge of Cancer's Warning Signs

Early detection of cancer is important because it is usually easier to treat—and possibly cure—when caught early. Do you know what signs to look for? Take this quiz to find out more.

1. Any sudden or progressive change in a mole's appearance could be a sign of skin cancer.

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That’s why it’s important to regularly check your skin for any changes in moles, freckles, or other skin marks, the American Cancer Society (ACS) says.

A. TrueB. False

2. A sore that doesn't heal could be a sign of skin cancer.

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Other signs include a mole, bump, or nodule that is scaly, lumpy, crusty, oozing, or bleeding; pain, itchiness, tenderness, or changes in sensation in a mole or growth; swelling, redness, or spread of color into the skin near a mole or growth; and a part of a mole’s pigmented area that used to be flat beginning to rise.

A. TrueB. False

3. One sign of malignant melanoma is a mole tinged with shades of tan, brown, black, or blue.

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Other signs include one half of a mole that doesn't match the other half; a mole with edges that are ragged, notched, or blurred; a mole with pigmentation that is uneven or changing; and a mole that is larger than a pencil eraser. Seek immediate medical attention if you have any of these symptoms, the ACS says.

A. TrueB. False

4. Changes, lumps, or hard masses in the testicles are signs of testicular cancer.

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In most cases of testicular cancer, the man has a lump on a testicle or notices that the testicle is swollen, the ACS says. The ACS recommends that a testicular exam be included as part of a man's general health checkup. See your healthcare provider if you detect any abnormalities in your testicles.

A. TrueB. False

5. A change in bowel habits—blood in the stool or chronic constipation—is a common symptom of stomach cancer.

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A change in bowel habits is a symptom of colon and rectal cancer. Other symptoms include rectal bleeding, abdominal cramping, and weight loss. Stomach cancer generally does not cause symptoms early in the disease. It may cause pain in the upper abdomen, nausea, or a feeling of "fullness" after eating only small amounts of food.

A. TrueB. False

6. Lumps, hard knots, or a thickening in the breast could indicate breast cancer.

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Mammography is an important tool for detecting breast cancer early on, when it’s easiest to treat. But the benefits and limitations of mammography vary based on factors like age and personal risk. Experts have different recommendations for mammography. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their healthcare provider about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. According to the ACS, there is a lack of evidence that clinical breast exams (CBEs) done by healthcare providers or by yourself are helpful for cancer screening. So the ACS does not recommend them. Still, all women should be familiar with how their breasts look and feel and report any changes to their healthcare provider. Women should talk with their healthcare provider about their personal risk factors and make a decision about whether they should have a CBE.

A. TrueB. False

7. A nagging cough or hoarseness could be signs of lung cancer.

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Other possible signs are a chest ache and increased sputum or blood in the sputum. These symptoms could be caused by something other than cancer, but be sure to have any of these checked out by your healthcare provider.

A. TrueB. False

8. Prostate cancer often has no symptoms in its early stages.

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Signs of advanced prostate cancer include difficulty in urination, back pain, trouble getting an erection, and blood in the urine.

A. TrueB. False

9. Symptoms of mouth or tongue cancer include a sore inside the mouth that doesn't heal and mouth pain that doesn't get better or go away.

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These cancers appear primarily in people who smoke and chew tobacco. Regular dental checkups that include a whole mouth exam can help detect these cancers early, the ACS says.

A. TrueB. False

10. Bladder cancer has no symptoms.

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The most common symptoms are blood in the urine or changes in bladder habits, the ACS says. These could be signs of other health problems, so be sure to tell your healthcare provider if you notice changes.

A. TrueB. False

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